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Montenegro J, L P Oliveira C, Armet AM, Berg A, Sharma AM, Mereu L, Cominetti C, Ghosh S, Richard C, Nguyen NK, Cani PD, Walter J, Prado CM. Impact of a Powdered Meal Replacement on Metabolism and Gut Microbiota (PREMIUM) in individuals with excessive body weight: a study protocol for a randomised controlled trial. BMJ Open 2023; 13:e070027. [PMID: 37709337 DOI: 10.1136/bmjopen-2022-070027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/16/2023] Open
Abstract
INTRODUCTION Excess body weight is associated with a state of low-grade chronic inflammation and alterations of the gut microbiome. Powdered meal replacements (PMR) have been shown to be an effective strategy for weight management; however, their effect on inflammation and the gut microbiome remains unclear. The aim of this 12-week randomised control clinical trial is to investigate the effects of PMR consumption, here given as a soy-yoghurt-honey formula, on inflammation, gut microbiome and overall metabolism in individuals with excessive body weight. METHODS AND ANALYSIS Healthy adults with excess body weight (n=88) are being recruited and randomly assigned to one of the following groups: (1) Control group (CON): maintaining usual diet for 12 weeks, or (2) PMR group: replacing morning and afternoon snacks daily with a PMR for 12 weeks. Participants are asked to maintain body weight throughout the study and fill out a journal with information about PMR consumption, body weight, food intake, appetite sensations and medications. Three study visits are required: baseline, week 6 and week 12. Outcome measures include systemic inflammatory biomarkers, gut microbiome composition, metabolic blood markers, host energy metabolism, body composition, appetite sensations and host gene expression profile. ETHICS AND DISSEMINATION This research protocol was approved by the University of Alberta Ethics Board (Pro00070712) and adheres to the Canadian Tri-Council Policy statement on the use of human participants in research. Procedures and potential risks are fully discussed with participants. Study findings will be disseminated in peer-reviewed journals, conference presentations and social media. TRIAL REGISTRATION NUMBER NCT03235804.
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Affiliation(s)
- Julia Montenegro
- Department of Agricultural, Food, and Nutritional Science, University of Alberta, Edmonton, Alberta, Canada
| | - Camila L P Oliveira
- Department of Agricultural, Food, and Nutritional Science, University of Alberta, Edmonton, Alberta, Canada
| | - Anissa M Armet
- Department of Agricultural, Food, and Nutritional Science, University of Alberta, Edmonton, Alberta, Canada
| | - Aloys Berg
- Faculty of Medicine, University of Freiburg, Freiburg im Breisgau, Germany
| | - Arya M Sharma
- Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Laurie Mereu
- Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
| | | | - Sunita Ghosh
- Department of Medical Oncology, University of Alberta, Edmonton, Alberta, Canada
| | - Caroline Richard
- Department of Agricultural, Food, and Nutritional Science, University of Alberta, Edmonton, Alberta, Canada
| | - Nguyen Khoi Nguyen
- Metabolism and Nutrition research group (MNUT), UCLouvain, Universite catholique de Louvain, Louvain Drug Research Institute, Brussels, Belgium
- Walloon Excellence in Life Sciences and BIOtechnology (WELBIO), WEL Research Institute, Wavre, Belgium
| | - Patrice D Cani
- Metabolism and Nutrition research group (MNUT), UCLouvain, Universite catholique de Louvain, Louvain Drug Research Institute, Brussels, Belgium
- Walloon Excellence in Life Sciences and BIOtechnology (WELBIO), WEL Research Institute, Wavre, Belgium
| | - Jens Walter
- Department of Agricultural, Food, and Nutritional Science, University of Alberta, Edmonton, Alberta, Canada
- APC Microbiome Ireland, School of Microbiology, and Department of Medicine, University College Cork - National University of Ireland, Cork, Ireland
| | - Carla M Prado
- Department of Agricultural, Food, and Nutritional Science, University of Alberta, Edmonton, Alberta, Canada
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Scollo P, Pecorino B, Scibilia G, Guardalà VFM, Ferrara M, Mereu L, D'Agate MG. Scollo's symmetric lateral levator myorrhaphy (SLLM) for correction of rectocele in six steps. Tech Coloproctol 2023; 27:497-498. [PMID: 36333612 DOI: 10.1007/s10151-022-02726-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2022] [Accepted: 10/28/2022] [Indexed: 11/06/2022]
Affiliation(s)
- P Scollo
- Department of Obstetrics and Gynecology, Cannizzaro Hospital, University of Enna "Kore", Catania, Italy
| | - B Pecorino
- Department of Obstetrics and Gynecology, Cannizzaro Hospital, University of Enna "Kore", Catania, Italy.
| | - G Scibilia
- Department of Obstetrics and Gynecology, "Giovanni Paolo II" Hospital, Ragusa, Italy
| | - V F M Guardalà
- Department of Obstetrics and Gynecology, Cannizzaro Hospital, University of Enna "Kore", Catania, Italy
| | - M Ferrara
- Department of Obstetrics and Gynecology, Cannizzaro Hospital, University of Enna "Kore", Catania, Italy
| | - L Mereu
- Department of Obstetrics and Gynecology, Cannizzaro Hospital, University of Enna "Kore", Catania, Italy
| | - M G D'Agate
- Department of Obstetrics and Gynecology, Cannizzaro Hospital, University of Enna "Kore", Catania, Italy
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Montenegro J, Oliveira C, Berg A, Sharma A, Mereu L, Walter J, Prado C. Comparison of Measured Versus Predicted Resting Energy Expenditure in Individuals With Excess Body Weight. Curr Dev Nutr 2022. [PMCID: PMC9193493 DOI: 10.1093/cdn/nzac057.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Objectives Assessing resting energy expenditure (REE) is important for determining energy requirements. Indirect calorimetry is usually not available in clinical settings and for this reason, predictive equations for estimating REE have been developed. Body composition influences REE; therefore, body compartments such fat-free mass (FFM) and fat mass (FM) should be considered in predictive equations. The aim of this study was to compare REE measured by indirect calorimetry with REE estimated from seven predictive equations that consider body composition in individuals with excess body weight. Methods This was a preliminary baseline data from a randomized controlled trial. REE was measured in adults with overweight and obesity using a whole-body calorimetry unit. Dual-energy X-ray absorptiometry was used to assess FM and FFM. Measured REE (mREE) was compared to seven predictive equations that incorporated FFM and FM. Age and body composition were compared between sexes using independent-samples t-test. A paired-samples t-test was used to compare mREE versus predicted REE (pREE). Bias and limits of agreement (LOA) were accessed by Bland-Altman analysis. pREE values between 95% and 105% of mREE were considered accurate. Results Twenty-one adults (n = 15 females, age: 27 ± 7 years, BMI: 29.0 ± 2.9 kg/m2, mREE: 1769 ± 342 kcal/day) were assessed. Age, FM, and FFM were not different between sexes (P > 0.05). The Muller et al., 2001 (Praxis 90: 1955–1963) and Horie et al., 2007 (Obesity 19: 1090–1094) equations were considered accurate and showed small bias, but high standard deviation (33.5 ± 178.2 and −51.4 ± 208.6 kcal/day) and wide LOAs (-316 to 383 and -460 to 357 kcal/day, respectively). However, when separated by sex, only the equation by Muller et al., 2001 was accurate for males (bias: −85.3 ± 161.4; LOA: -402 to 231 kcal/day) and only the equation by Horie et al., 2007 was accurate for females (bias: 28.0 ± 162.4; LOA: -290 to 346 kcal/day). All other equations (5) underestimated mREE. Conclusions The equations by Muller et al., 2001 and Horie et al., 2007 can be used for estimating REE in adults with excess body weight. The use of body composition per se in not enough to ensure accuracy of predictive equations. Funding Sources Almased® (Almased USA, Inc., Wellington, FL, USA) and Alberta Diabetes Institute (University of Alberta, Edmonton, AB, Canada).
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Wang T, Vu A, Mereu L, Ghosh M. Malignant insulinoma in a patient with hypoglycemia. CMAJ 2022; 194:E332-E335. [PMID: 35256389 PMCID: PMC9053995 DOI: 10.1503/cmaj.211002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Affiliation(s)
- Tianqi Wang
- Division of Endocrinology and Metabolism (Vu, Mereu, Ghosh) and Division of Internal Medicine (Wang), Department of Medicine, University of Alberta, Edmonton, Alta.
| | - Albert Vu
- Division of Endocrinology and Metabolism (Vu, Mereu, Ghosh) and Division of Internal Medicine (Wang), Department of Medicine, University of Alberta, Edmonton, Alta
| | - Laurie Mereu
- Division of Endocrinology and Metabolism (Vu, Mereu, Ghosh) and Division of Internal Medicine (Wang), Department of Medicine, University of Alberta, Edmonton, Alta
| | - Mahua Ghosh
- Division of Endocrinology and Metabolism (Vu, Mereu, Ghosh) and Division of Internal Medicine (Wang), Department of Medicine, University of Alberta, Edmonton, Alta
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Timmerman D, Planchamp F, Bourne T, Landolfo C, du Bois A, Chiva L, Cibula D, Concin N, Fischerova D, Froyman W, Gallardo G, Lemley B, Loft A, Mereu L, Morice P, Querleu D, Testa AC, Vergote I, Vandecaveye V, Scambia G, Fotopoulou C. ESGO/ISUOG/IOTA/ESGE Consensus Statement on preoperative diagnosis of ovarian tumors. Ultrasound Obstet Gynecol 2021; 58:148-168. [PMID: 33794043 DOI: 10.1002/uog.23635] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
The European Society of Gynaecological Oncology (ESGO), the International Society of Ultrasound in Obstetrics and Gynecology (ISUOG), the International Ovarian Tumour Analysis (IOTA) group and the European Society for Gynaecological Endoscopy (ESGE) jointly developed clinically relevant and evidence-based statements on the preoperative diagnosis of ovarian tumors, including imaging techniques, biomarkers and prediction models. ESGO/ISUOG/IOTA/ESGE nominated a multidisciplinary international group, including expert practising clinicians and researchers who have demonstrated leadership and expertise in the preoperative diagnosis of ovarian tumors and management of patients with ovarian cancer (19 experts across Europe). A patient representative was also included in the group. To ensure that the statements were evidence-based, the current literature was reviewed and critically appraised. Preliminary statements were drafted based on the review of the relevant literature. During a conference call, the whole group discussed each preliminary statement and a first round of voting was carried out. Statements were removed when consensus among group members was not obtained. The voters had the opportunity to provide comments/suggestions with their votes. The statements were then revised accordingly. Another round of voting was carried out according to the same rules to allow the whole group to evaluate the revised version of the statements. The group achieved consensus on 18 statements. This Consensus Statement presents these ESGO/ISUOG/IOTA/ESGE statements on the preoperative diagnosis of ovarian tumors and the assessment of carcinomatosis, together with a summary of the evidence supporting each statement.
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Affiliation(s)
- D Timmerman
- Department of Development and Regeneration, KU Leuven, Leuven, Belgium
- Department of Obstetrics and Gynecology, University Hospitals Leuven, Leuven, Belgium
| | - F Planchamp
- Clinical Research Unit, Institut Bergonie, Bordeaux, France
| | - T Bourne
- Department of Development and Regeneration, KU Leuven, Leuven, Belgium
- Department of Obstetrics and Gynecology, University Hospitals Leuven, Leuven, Belgium
- Department of Metabolism, Digestion and Reproduction, Queen Charlotte's & Chelsea Hospital, Imperial College, London, UK
| | - C Landolfo
- Department of Woman, Child and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - A du Bois
- Department of Gynaecology and Gynaecological Oncology, Evangelische Kliniken Essen-Mitte, Essen, Germany
| | - L Chiva
- Department of Gynaecology and Obstetrics, University Clinic of Navarra, Madrid, Spain
| | - D Cibula
- Department of Obstetrics and Gynaecology, First Faculty of Medicine, Charles University, General University Hospital in Prague, Prague, Czech Republic
| | - N Concin
- Department of Gynaecology and Gynaecological Oncology, Evangelische Kliniken Essen-Mitte, Essen, Germany
- Department of Obstetrics and Gynecology, Medical University of Innsbruck, Innsbruck, Austria
| | - D Fischerova
- Department of Obstetrics and Gynaecology, First Faculty of Medicine, Charles University, General University Hospital in Prague, Prague, Czech Republic
| | - W Froyman
- Department of Obstetrics and Gynecology, University Hospitals KU Leuven, Leuven, Belgium
| | - G Gallardo
- Department of Radiology, University Clinic of Navarra, Madrid, Spain
| | - B Lemley
- Patient Representative, President of Kraefti Underlivet (KIU), Denmark
- Chair Clinical Trial Project of the European Network of Gynaecological Cancer Advocacy Groups, ENGAGe
| | - A Loft
- Department of Clinical Physiology, Nuclear Medicine & PET, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - L Mereu
- Department of Gynecology and Obstetrics, Gynecologic Oncology Unit, Santa Chiara Hospital, Trento, Italy
| | - P Morice
- Department of Gynaecological Surgery, Institut Gustave Roussy, Villejuif, France
| | - D Querleu
- Division of Gynecologic Oncology, Fondazione Policlinico Universitario A Gemelli IRCCS, Rome, Italy
- Department of Obstetrics and Gynecologic Oncology, University Hospital, Strasbourg, France
| | - A C Testa
- Department of Woman, Child and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
- Institute of Obstetrics and Gynecology, Università Cattolica del Sacro Cuore, Rome, Italy
| | - I Vergote
- Department of Obstetrics and Gynaecology and Gynaecologic Oncology, University Hospital Leuven, Leuven Cancer Institute, Leuven, Belgium
| | - V Vandecaveye
- Department of Radiology, University Hospitals Leuven, Leuven, Belgium
- Division of Translational MRI, Department of Imaging & Pathology KU Leuven, Leuven, Belgium
| | - G Scambia
- Department of Woman, Child and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
- Institute of Obstetrics and Gynecology, Università Cattolica del Sacro Cuore, Rome, Italy
| | - C Fotopoulou
- Department of Gynecologic Oncology, Hammersmith Hospital, Imperial College, London, UK
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Timmerman D, Planchamp F, Bourne T, Landolfo C, du Bois A, Chiva L, Cibula D, Concin N, Fischerova D, Froyman W, Gallardo G, Lemley B, Loft A, Mereu L, Morice P, Querleu D, Testa C, Vergote I, Vandecaveye V, Scambia G, Fotopoulou C. ESGO/ISUOG/IOTA/ESGE Consensus Statement on preoperative diagnosis of ovarian tumours. Facts Views Vis Obgyn 2021; 13:107-130. [PMID: 34107646 PMCID: PMC8291986 DOI: 10.52054/fvvo.13.2.016] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
The European Society of Gynaecological Oncology (ESGO), the International Society of Ultrasound in Obstetrics and Gynecology (ISUOG), the International Ovarian Tumour Analysis (IOTA) group and the European Society for Gynaecological Endoscopy (ESGE) jointly developed clinically relevant and evidence-based statements on the preoperative diagnosis of ovarian tumours, including imaging techniques, biomarkers and prediction models. ESGO/ISUOG/IOTA/ESGE nominated a multidisciplinary international group, including expert practising clinicians and researchers who have demonstrated leadership and expertise in the preoperative diagnosis of ovarian tumours and management of patients with ovarian cancer (19 experts across Europe). A patient representative was also included in the group. To ensure that the statements were evidence-based, the current literature was reviewed and critically appraised. Preliminary statements were drafted based on the review of the relevant literature. During a conference call, the whole group discussed each preliminary statement and a first round of voting was carried out. Statements were removed when a consensus among group members was not obtained. The voters had the opportunity to provide comments/suggestions with their votes. The statements were then revised accordingly. Another round of voting was carried out according to the same rules to allow the whole group to evaluate the revised version of the statements. The group achieved consensus on 18 statements. This Consensus Statement presents these ESGO/ISUOG/IOTA/ESGE statements on the preoperative diagnosis of ovarian tumours and the assessment of carcinomatosis, together with a summary of the evidence supporting each statement.
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Mereu L, Dalpra F, Terreno E, Pertile R, Angioni S, Tateo S. Mini-Laparoscopic Repair of Apical Pelvic Organ Prolapse (POP) by Lateral Suspension with Mesh. Facts Views Vis Obgyn 2018; 10:139-145. [PMID: 31191848 PMCID: PMC6548408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND The aim of the present study is to analyze the feasibility, safety and learning curve of Mini- Laparoscopic Lateral suspension (LLS) for the treatment of apical and anterior defects following pelvic organ prolapse. METHODS This is a cohort study on a retrospective series of 35 consecutive patients who underwent Mini-LLS for symptomatic POP between January 2014 and July 2016. All 35 patients were operated at the Gynaecological Unit in S. Chiara Hospital by two senior surgeons (S. Tateo and L. Mereu) and by a team with optimal skills in laparoscopic surgery. Patients were divided in two groups according to two different chronological phases: phase 1 identified the initial 12 cases, phase 2 the last 23 cases. We collected pre-, peri- and post-operative information to analyze the surgical outcomes and learning curve after Mini-LLS procedures. RESULTS The mean LLS-Overall Time (OT) was 107.6 min (range, 185- 63 min). None of the patients had intra-operative complications. No conversion to laparotomy was necessary. The mean post-operative hospital stay was 58 hours in total (SD +/-22). Only in 3 cases (8.6 %) post-operative grade I complications were observed. Recurrence of POP was observed in 3 cases (8.6 %) during a mean follow up of 18 months. The mean OT decreased with experience, in particular after the first 12 cases (phase 1: 113.54 minutes versus phase 2: 104.43 minutes). In consequence, the reduction of time per procedure was statistically significant considering the Cusum Time (CT) (P < .05). CONCLUSIONS Mini-LLS with mesh is a safe and reproducible technique with good anatomical results, low complication rates and a short learning curve.
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Affiliation(s)
- L Mereu
- Department of Obstetrics and Gynecology, Santa Chiara Hospital of Trento, Italy
| | - F Dalpra
- Department of Obstetrics and Gynecology, Santa Chiara Hospital of Trento, Italy
| | - E Terreno
- Department of Obstetrics and Gynecology, Santa Chiara Hospital of Trento, Italy
| | - R Pertile
- Department of Clinical Epidemiology, Santa Chiara Hospital of Trento, Italy
| | - S Angioni
- Department of Obstetrics and Gynaecology, University of Cagliari, Italy
| | - S Tateo
- Department of Obstetrics and Gynecology, Santa Chiara Hospital of Trento, Italy
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Corrado G, Mereu L, Bogliolo S, Cela V, Freschi L, Carlin R, Gardella B, Mancini E, Tateo S, Spinillo A, Vizza E. Robotic single site staging in endometrial cancer: A multi-institution study. Eur J Surg Oncol 2016; 42:1506-11. [DOI: 10.1016/j.ejso.2016.08.014] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2016] [Revised: 07/05/2016] [Accepted: 08/18/2016] [Indexed: 01/14/2023] Open
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Alagiakrishnan K, Sankaralingam S, Ghosh M, Mereu L, Senior P. Antidiabetic drugs and their potential role in treating mild cognitive impairment and Alzheimer's disease. Discov Med 2013; 16:277-286. [PMID: 24333407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
The incidence of both diabetes mellitus (DM) and dementia increases with aging and the incidence of dementia are higher in people with diabetes. Epidemiological and pathological data suggest that DM contributes to mild cognitive impairment (MCI) and dementia. DM seems to be an independent risk factor for MCI and Alzheimer's disease (AD) and is associated with more rapid cognitive decline. Recent evidence points out that insulin affects central nervous system functions, and can modulate cognitive functions. Impaired insulin signaling and insulin resistance in brain have been found to play an important role in the pathogenesis of AD. Human studies have shown that some oral antidiabetic medications can improve cognition in patients with MCI and AD. Intranasal insulin has also been shown to improve memory and cognitive abilities in MCI and AD patients. While it remains unclear whether management of diabetes will reduce the incidence of MCI and AD, emerging evidence suggests that diabetes therapies may improve cognitive function.
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Mencaglia L, Mereu L, Carri G, Arena I, Khalifa H, Tateo S, Angioni S. Single port entry – Are there any advantages? Best Pract Res Clin Obstet Gynaecol 2013; 27:441-55. [DOI: 10.1016/j.bpobgyn.2012.12.002] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2012] [Accepted: 12/06/2012] [Indexed: 12/11/2022]
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Mereu L, Carri G, Khalifa H. Robotic single port total laparoscopic hysterectomy for endometrial cancer patients. Gynecol Oncol 2012; 127:644. [PMID: 22871468 DOI: 10.1016/j.ygyno.2012.07.129] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2012] [Accepted: 07/31/2012] [Indexed: 02/07/2023]
Affiliation(s)
- L Mereu
- Department of Gynecology, Centro Oncologico Fiorentino, Sesto Fiorentino (FI), Italy.
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Li F, Ozkaya E, Akula K, De Sutter P, Oktay K, Rives N, Milazzo JP, Perdrix A, Bironneau A, Travers A, Mace B, Liard A, Bachy B, Elbaz V, Vannier JP, Delle Piane L, Dolfin E, Salvagno F, Molinari E, Gennarelli G, Marchino GL, Revelli A, Durmaz A, Komurcu N, Sanchez-Serrano M, Dolmans MM, Greve T, Pellicer A, Donnez J, Yding Andersen C, Vlismas A, Sabatini L, Edwards C, Mohamed M, Caragia A, Pepas L, Al-Shawaf T, Sanhueza P, Carrasco I, Rios M, Donoso P, Salinas R, Enriquez R, Saez V, Gonzalez P, Aydin Y, Cepni I, Ocal P, Aydin B, Aydogan B, Salahov R, Idil M, Akman L, Akdogan A, Sahin G, Terek C, Ozsaran A, Dikmen Y, Goker ENT, Tavmergen E, Grynberg M, Poulain M, Sebag Peyrelevade S, Treves R, Frydman N, Fanchin R, Borras A, Manau D, Espinosa N, Calafell JM, Moreno V, Civico S, Fabregues F, Balasch J, Kim MK, Lee DR, Cha SK, Lee WS, Kim YS, Won HJ, Han JE, Yoon TK, Torgal M, Bravo I, Metello JL, Sanches F, Sa e Melo P, Silber S, Ernst E, Andersen C, Naasan M, Oluyede G, Kirkham C, Ciprike V, Mocanu E, Martinez-Madrid B, Encinas T, Tinetti P, Jimenez L, Gilabert JA, Picazo RA, Wiweko B, Maidarti M, Bastings L, Liebenthron J, Westphal JR, Beerendonk CCM, Gerritse R, Braat DDM, Montag M, Peek R, Bernstein S, Wiesemann C, Karimi M, Omani Samani R, Labied S, Delforge YVES, Munaut C, Blacher S, Colige A, Delcombel R, Henry L, Fransolet M, Perrier d'Hauterive S, Nisolle M, Foidart JM, Sakai H, Sakamoto E, Kuchiki M, Doshida M, Toya M, Kyono K, Kyoya T, Ishikawa T, Nakamura Y, Shibuya Y, Tomiyama T, Kyono K, Sakamoto E, Sakai H, Kuchiki M, Sato K, Nakajo Y, Kyono K, Hashemifesharaki M, Falcone P, Lofiego V, Pisoni M, Ricci S, Pilla F, Mereu L, Mencaglia L, Westphal JR, Gerritse R, Beerendonk CCM, Bastings L, Braat DDM, Peek R, Schmidt KT, Nyboe Andersen A, Yding Andersen C, Noyes N, Melzer K, Fino ME, Druckenmiller S, Smith M, Knopman JM, Devesa M, Coroleu B, Tur R, Gonzalez C, Rodriguez I, Veiga A, Barri PN, Courbiere B, Decanter C, Bringer-Deutsch S, Rives N, Mirallie S, Pech JC, De Ziegler D, Carre-Pigeon F, May-Panloup P, Sifer C, Amice V, Schweitzer T, Porcu-Buisson G, Gook D, Archer J, Edgar DH, Maldonado I, Varghese A, Lopez P, Cervantes E, Gongora A, Sharma R, Granja J, Marquez MT, Agarwal A. MALE AND FEMALE FERTILITY PRESERVATION. Hum Reprod 2012. [DOI: 10.1093/humrep/27.s2.82] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Simpson SH, Gamble JM, Mereu L, Chambers T. Effect of aspirin dose on mortality and cardiovascular events in people with diabetes: a meta-analysis. J Gen Intern Med 2011; 26:1336-44. [PMID: 21647746 PMCID: PMC3208465 DOI: 10.1007/s11606-011-1757-y] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2010] [Revised: 03/09/2011] [Accepted: 05/03/2011] [Indexed: 12/11/2022]
Abstract
OBJECTIVES Pharmacologic evidence suggests adequate antiplatelet activity in diabetic patients requires >100 mg aspirin daily, yet recent trials have used ≤100 mg daily. This meta-analysis explored the relationship between aspirin dose and prevention of cardiovascular events. DATA SOURCES Six electronic databases were searched using database-appropriate terms for aspirin, diabetes, and comparative study from inception until February 2010. REVIEW METHODS Randomized controlled trials and cohort studies comparing aspirin to no antiplatelet therapy were included if they reported cardiovascular events as pre-specified outcomes, aspirin dose, and number of diabetic patients. Studies were stratified by daily aspirin dose (≤100 mg; 101-325 mg; >325 mg) and pooled risk ratios (RR) were calculated using random effects models. All-cause mortality was the primary outcome of interest. Cardiovascular-related mortality, myocardial infarction, and stroke were secondary outcomes. RESULTS Data for diabetic patients were available from 21 studies (n = 17,522). Overall, 1,172 (15.4%) of 7,592 aspirin users and 1,520 (18.4%) of 8,269 controls died (p = 0.31). The pooled RRs were 0.89 (95% CI: 0.72-1.10; p = 0.27) from 13 studies using ≤100 mg (I(2) = 64%); 0.89 (95% CI: 0.61-1.30; p = 0.55) from four studies using 101-325 mg (I(2) = 83%); and 0.96 (95% CI: 0.85-1.08; p = 0.50) from eight studies using >325 mg (I(2) = 0%). Aspirin use was associated with a significantly lower risk of mortality (RR: 0.82; 95% CI: 0.69-0.98; p = 0.03) in 13 secondary prevention studies (I(2) = 27%), whereas aspirin use in seven primary prevention studies (I(2) = 0%) was not (RR: 1.01; 95% CI 0.85-1.19; p = 0.94). A substantial amount of heterogeneity was observed amongst studies in all outcomes. Although inclusion of cohort studies was a major source of heterogeneity, stratification by study design did not reveal a significant dose-response relationship. CONCLUSIONS/INTERPRETATION This summary of available data does not support an aspirin dose-response effect for prevention of cardiovascular events in diabetic patients. However, the systematic review identified an important gap in randomized controlled trial evidence for using 101-325 mg aspirin daily in diabetes.
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Affiliation(s)
- Scot H. Simpson
- Faculty of Pharmacy & Pharmaceutical Sciences, 3126 Dentistry / Pharmacy Centre, University of Alberta, Edmonton, AB Canada T6G 2N8
| | | | - Laurie Mereu
- Faculty of Medicine & Dentistry, University of Alberta, Edmonton, AB Canada
| | - Thane Chambers
- University of Alberta Library Services, Edmonton, AB Canada
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Abstract
Hypoglycemia is a common clinical problem in elderly patients with diabetes. Aging modifies the counterregulatory and symptomatic responses to hypoglycemia. Hypoglycemia in the elderly is not only due to tight blood sugar control, but also due to a multitude of other factors. Hypoglycemia often occurs with insulin, sulfonylureas, or meglitinide therapy. However, other causes may also contribute to hypoglycemia, such as decreased cognition, renal impairment, or polypharmacy. The presenting features of hypoglycemia may be atypical and misinterpreted, resulting in delayed treatment. Morbidity is greater in elderly patients, and the risk of progression to severe hypoglycemia is high because of their altered symptom profile, diminished symptom intensity, and altered glycemic thresholds. Hypoglycemia seems to be the main limiting factor in their glycemic control. In this article we discuss strategies to prevent hypoglycemic episodes.
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Affiliation(s)
- Kannayiram Alagiakrishnan
- Division of Geriatric Medicine, Department of Medicine, University of Alberta, Edmonton, Alberta, T6G 2G3, Canada.
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Landi S, Mereu L, Indraccolo U, Favero R, Fiaccavento A, Zaccoletti R, Clarizia R, Barbieri F. Laparoscopic excision of endometriosis may require unilateral parametrectomy. JSLS 2010; 13:496-503. [PMID: 20202390 PMCID: PMC3030782 DOI: 10.4293/108680809x12589998404047] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE We investigated the effects of laparoscopic excision of endometriosis with unilateral parametrectomy on bladder, rectal, and sexual function as well as patient satisfaction. METHODS Women who underwent this procedure between February 1, 2006 and November 15, 2007 were enrolled. Patient characteristics, pre- and postoperative findings, and follow-up data were retrospectively collected from a computerized database. RESULTS Twelve patients were enrolled in the study. All of the symptoms except dysuria improved after surgery, worsening long after the operation. It seems that all parameters including sexuality, micturition, and defecation are equally important in regards to the final judgement of satisfaction, with a trend towards amelioration long after the operation. CONCLUSIONS Unilateral parametrectomy may offer successful results in terms of patient satisfaction despite some impairment in bladder, bowel, and sexual function. The risk of permanent functional impairment is high; therefore, surgeons need to maintain the integrity of the contralateral nerve pathway. This is highly important, because pain relief seems to be partially involved in the final judgement of postoperation satisfaction.
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Affiliation(s)
- S Landi
- Department of Obstetrics and Gynecology, Ospedale Sacro Cuore, Verona, Italy
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16
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Stepniewska A, Pomini P, Bruni F, Mereu L, Ruffo G, Ceccaroni M, Scioscia M, Guerriero M, Minelli L. Laparoscopic treatment of bowel endometriosis in infertile women. Hum Reprod 2009; 24:1619-25. [PMID: 19357136 DOI: 10.1093/humrep/dep083] [Citation(s) in RCA: 94] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND The purpose of the study was to determine the influence of bowel endometriosis on fertility, and to study whether its removal improves fecundity in women with endometriosis-associated infertility. METHODS Three groups of infertile patients were included in the study. Group A (60 women) consisted of patients who underwent surgery for endometriosis with colorectal segmental resection. In group B, 40 patients with evidence of bowel endometriosis underwent endometriosis removal without bowel resection. Group C consisted of 55 women who underwent surgery for moderate or severe endometriosis with at least one endometrioma and deep infiltrating endometriosis but without bowel involvement. The women were clinically evaluated before laparoscopy and then at 1 month, at 6 months and at each year up to 4 years after surgery. Main outcome measures were surgical complications as well as post-operative pregnancy rate, time to conception and monthly fecundity rate. RESULTS The monthly fecundity rates (MFR) in groups A, B and C were 2.3, 0.84 and 3.95%, respectively. The difference in the MFR between groups was significant (P < 0.05). CONCLUSIONS The presence of bowel infiltration by endometriosis seems to negatively influence the reproductive outcome in women with endometriosis-associated infertility. The complete removal of endometriosis with bowel segmental resection seems to offer better results in terms of post-operative fertility.
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Affiliation(s)
- A Stepniewska
- Departments of Obstetrics and Gynecology, Ospedale Sacro Cuore, Via Don Sempreboni 5, Negrar 37024, Verona, Italy.
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17
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Fiaccavento A, Mereu L, Ruffo G, Landi S, Barbieri F, Zaccoletti R, Stepniewska A, Pontrelli G, Minelli L. Laparoscopic Treatment of Deep Endometriosis with Segmental Colorectal Resection: Short-Term Morbidity. J Minim Invasive Gynecol 2008. [DOI: 10.1016/j.jmig.2008.09.267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Abstract
Today, hysterectomy is, after caesarean section, the most frequent surgical intervention performed in fertile women. Introduced in 1989, laparoscopic hysterectomy remains poorly diffused: today, less than 5% of all hysterectomies remain done by laparoscopy. Nevertheless after a correct learning curve, laparoscopic hysterectomy finds perfect indications in benign and even some malignant indications. In these conditions, the complication rate is similar to those of the other surgical routes. Currently the limitations of this technique are the very bulky uterus, contraindicated uterine morcellation, the lengthening of the operative time potentially generated by this technique, and the lack of experienced instructors.
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Affiliation(s)
- V Thoma
- IRCAD/EITS, 1, place de l'Hôpital, B.P. 426, 67091 Strasbourg, France.
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Tateo S, Mereu L, Salamano S, Klersy C, Barone M, Spyropoulos AC, Piovella F. Ovarian cancer and venous thromboembolic risk. Gynecol Oncol 2005; 99:119-25. [PMID: 15990161 DOI: 10.1016/j.ygyno.2005.05.009] [Citation(s) in RCA: 83] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2005] [Revised: 05/12/2005] [Accepted: 05/18/2005] [Indexed: 10/25/2022]
Abstract
OBJECTIVE To determine the incidence and the prognostic factors of objectively diagnosed deep vein thrombosis (DVT) and pulmonary embolism (PE) in patients with epithelial ovarian malignancy. METHODS We reviewed the records of all patients with epithelial ovarian cancer who were diagnosed, treated, and followed-up at our institution between 1990 and 2001. Data were collected regarding age, body mass index, previous DVT and PE, menopause status, FIGO stage, grade, histology, type of surgery, residual disease, first line chemotherapy, and relapse status. RESULTS Of the 253 cases, the overall incidence of symptomatic venous thromboembolic events (VTE) was 16.6% (42 patients): 1.6% (4) with PE and 15% (38) with DVT. 8 events (3.2%) were detected before tumor diagnosis, 6 (2.4%) in the postoperative period, 16 (6.4%) during first line chemotherapy and 12 (4.8%) throughout the follow-up period. Risk factors associated with occurrence of VTE were: at diagnosis, history of deep vein thrombosis (P = 0.001); during chemotherapy, older age (P = 0.017), larger body mass index (P = 0.019), FIGO stage 2c-4 (P = 0.004), no surgery (P = 0.003), and presence of residual tumor (P = 0.026). None of the considered risk factors were found to be predictors of VTE postoperatively. The multivariate regression analysis found that residual tumor, age, and body mass index were independent prognostic factors. CONCLUSION The incidence of VTE throughout the entire history of ovarian malignancy is high. Prognostic factors could be used to establish prophylaxis protocols based on risk stratification.
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Affiliation(s)
- S Tateo
- Department of Obstetrics and Gynecology, IRCCS Policlinico San Matteo, Piazzale Golgi, 27100 Pavia, Italy.
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Merisio C, Berretta R, Gualdi M, Pultrone DC, Anfuso S, Agnese G, Aprile C, Mereu L, Salamano S, Tateo S, Melpignano M. Radioguided sentinel lymph node detection in vulvar cancer. Int J Gynecol Cancer 2005; 15:493-7. [PMID: 15882175 DOI: 10.1111/j.1525-1438.2005.15314.x] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Lymph node status is the most important prognostic factor in vulvar cancer. Histologically, sentinel nodes may be representative of the status of the other regional nodes. Identification and histopathologic evaluation of sentinel nodes could then have a significant impact on clinical management and surgery. The aim of this study was to evaluate the feasibility and diagnostic accuracy of sentinel lymph node detection by preoperative lymphoscintigraphy with technetium-99 m-labeled nanocolloid, followed by radioguided intraoperative detection. Nine patients with stage T1, N0, M0, and 11 patients with stage T2, N0, M0 squamous cell carcinoma of the vulva were included in the study. Only three cases had lesions exceeding 3.5 cm in diameter. Sentinel nodes were detected in 100% of cases. A total of 30 inguinofemoral lymphadenectomies were performed, with a mean of 10 surgically removed nodes. Histological examination revealed 17 true negative sentinel nodes, 2 true positive, and 1 false negative. In our case series, sentinel lymph node detection had a 95% diagnostic accuracy, with only one false negative. Based on literature evidence, the sentinel node procedure is feasible and reliable in vulvar cancer; however, the value of sentinel node dissection in the treatment of early-stage vulvar cancer still needs to be confirmed.
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Affiliation(s)
- C Merisio
- Maternal and Infant Care Department, University of Parma, Parma, Italy.
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21
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Merisio C, Berretta R, Gualdi M, Pultrone DC, Anfuso S, Agnese G, Aprile C, Mereu L, Salamano S, Tateo S, Melpignano M. Radioguided sentinel lymph node detection in vulvar cancer. Int J Gynecol Cancer 2005. [DOI: 10.1136/ijgc-00009577-200505000-00013] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Lymph node status is the most important prognostic factor in vulvar cancer. Histologically, sentinel nodes may be representative of the status of the other regional nodes. Identification and histopathologic evaluation of sentinel nodes could then have a significant impact on clinical management and surgery. The aim of this study was to evaluate the feasibility and diagnostic accuracy of sentinel lymph node detection by preoperative lymphoscintigraphy with technetium-99 m–labeled nanocolloid, followed by radioguided intraoperative detection. Nine patients with stage T1, N0, M0, and 11 patients with stage T2, N0, M0 squamous cell carcinoma of the vulva were included in the study. Only three cases had lesions exceeding 3.5 cm in diameter. Sentinel nodes were detected in 100% of cases. A total of 30 inguinofemoral lymphadenectomies were performed, with a mean of 10 surgically removed nodes. Histological examination revealed 17 true negative sentinel nodes, 2 true positive, and 1 false negative. In our case series, sentinel lymph node detection had a 95% diagnostic accuracy, with only one false negative. Based on literature evidence, the sentinel node procedure is feasible and reliable in vulvar cancer; however, the value of sentinel node dissection in the treatment of early-stage vulvar cancer still needs to be confirmed.
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Melpignano M, Merisio C, Gualdi M, Berretta R, Agnese G, Tateo S, Mereu L, Preti E, Aprile C. SENTINEL LYMPHNODES RADIOGUIDED LOCALIZATION IN VULVAR CANCER. Int J Gynecol Cancer 2003. [DOI: 10.1136/ijgc-00009577-200303001-00382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
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Mereu L, Salamano S, Preti E, Coscia D, Piovella F, Tateo S. VENOUS THROMBOEMBOLISM INCIDENCE IN OVARIAN CANCER PATIENTS. Int J Gynecol Cancer 2003. [DOI: 10.1136/ijgc-00009577-200303001-00155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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